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Background

Success of most periodontal treatment modalities as demonstrated by clinical parameters
is well-established. These measurements, however, do not capture the full impact of
treatment on the oral health status and health-related quality of life (QoL) of the
patients. This study aims to assess the effectiveness of periodontal treatment provided
at selected government specialist dental clinics using patient-reported outcomes.

Materials and methods

This prospective study involved patients who visited five randomly selected government
periodontics clinics in Malaysia for treatment of periodontitis. Following ethics
approval, all patients meeting the selection criteria were recruited over a period
of eight months and comprehensive periodontal treatment ensued for a period of twelve
months. Diagnosis of periodontitis was based on presence of periodontal pockets at
least 4mm deep. At the end of the study period periodontal treatment outcomes were
assessed using two patient-centred outcome measures: Oral Health Impact Profile (OHIP-14S)
and Euroqol EQ-5D-3L index.

Results

A total of 145 patients started periodontal treatment but only 139 (95.8%) completed
the 12-month study period. At post-treatment, patients had significantly improved
oral health-related QoL (P<0.001) Wilcoxon Signed Rank Test; median OHIP-14S score
of 7.0 at post-treatment vs 22.0 at baseline). Further, Cohen’s effect size was calculated
to be 1.1, suggesting practical significance. Improvement in general health status
was indicated by gain in EQ5D-utility and Visual Analogue scores at post-treatment
(P<0.001 Wilcoxon Signed Rank Test; median utility score of 1.0 vs 0.73 and median
VAS of 80 vs 70 at post-treatment and baseline respectively). Improvements in clinical
parameters also reflected positive outcomes consistent with that of patient-reported
outcomes.

Conclusion

Periodontal treatment provided at the selected government periodontics clinics in
Malaysia is effective in improving oral health status and health-related quality of
life of the patients. Employing patient reported outcome measures in assessing effectiveness
of dental health services will be an added value in providing high quality patient-centred
healthcare.